16: Incontinent Nostalgia

In this story, a 63-year-old woman has been living in an oculogyric-like trance suffering from post-encephalitic Parkinsonism since she was 18. For the past 24 years the symptoms seemed to be at their worst, where she exhibited myoclonus- displaying jerky movements, akinetic- the loss of the normal ability to move muscles, Apathetic- no feelings of interest, concern or enthusiasm, and oculogyric- eyes rolling back.

The portion of the brain responsible for this anomaly is found in the midbrain and more specifically found in an area known as the basal ganglia. Part of what constitutes the basal ganglia is the Substania Nigra, which is divided into two parts the substantia nigra pars compacta, and the substantia nigra reticulata. Through the interaction between the striatum (also in the midbrain) and the substantia nigra allows for motor movements to occur. In Parkinson patients the dopaminergic neurons in the substantia nigra die off, preventing the striatum from properly doing its job and resulting in a loss of motor activity.

In order to try to alleviate the patients symptoms she was treated with L-Dopa a precursor for Dopamine, that can easily pass through the blood brain barrier. After receiving her first treatments of L-Dopa, it almost seemed to work as a time machine. It not only brought her back to a younger age, where she was able to recall contemporary events, social mannerisms, and every word of a song she hasn’t heard in 40 years, but also her symptoms regressed back to the early stages. Where during these early stages she had more control over her movements as well as she had a dramatic release from her Parkinsonism and oculogyric-trance.

Although Parkinson’s is a common illness that many deal with today, post-encephalitic Parkinsonism is extremely rare. Post-encephalitic Parkinsonism is believed to be attributed to the Spanish flu epidemic from the early 1900’s. What made this case study so unique isn’t how the treatment of L-Dopa relieved the physical symptoms of Parkinson’s, but how it led to an overwhelming and uncontrollable outpour of memories from 40 years previous. Doctors also tried to decrease the dose of L-Dopa that resulted in the patient’s complete loss of the memories she has previously been able to recall. It seemed that this recollection had more to do with a large excitation in the brain from the increased dose of L-Dopa.